Individual
DR. LEE A BIBLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9200 W WISCONSIN AVE, ELECTROPHYSIOLOGY/CARDIOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-0533
(414) 805-0454
Mailing address
9200 W WISCONSIN AVE, ELECTROPHYSIOLOGY/CARDIOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-0533
(414) 805-0454
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
44995
WI
207RC0000X
Cardiovascular Disease Physician
Primary
44995
WI
207RC0001X
Clinical Cardiac Electrophysiology Physician
44995
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008000261I
HUMANA
—
05
—
1740230275
—
WI
Enumeration date
05/12/2006
Last updated
01/30/2013
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